Salicylic Acid

DEA Class; Rx, OTC

Common Brand Names; Compound W, Compound W for Kids, Dr. Scholl’s Advanced Pain Relief Corn Removers, Dr. Scholl’s Callus Removers, Dr. Scholl’s Clear Away, Dr. Scholl’s Clear Away OneStep, Dr. Scholl’s Clear Away Plantar, Dr. Scholl’s Corn Removers, Dr. Scholl’s Moisturizing Corn Remover Kit, Dr. Scholl’s OneStep Corn Removers, DuoPlant, Durasal, Keralyt, Mediplast, Trans-Ver-Sal AdultPatch, Trans-Ver-Sal PediaPatch, Trans-Ver-Sal PlantarPatch, Sal-Acid, Virasal, Psoriasin Medicated Wash

• Keratolytic Agents

salicylic acid acne (OTC)

• Classes: Acne Agents, Topical

Oral retinoid; synthetic 13-cis isomer of naturally occurring tretinoin
Used primarily for severe, recalcitrant nodular acne
Due to teratogenicity potential, only available through isotretinoin iPLEDGE REMs program

Indicated for the treatment of severe recalcitrant cystic acne vulgaris (nodular acne) in patients with multiple inflammatory nodules with a diameter of at least 5 mm.

Hypersensitivity

Prolonged use or application to large areas (risk for salicylism)

Children < 2 years

Virasal

• Impaired circulaiton (diabetes)
• Warts with hair growth or on face
• Birthmarks
• Moles

Facial warts or warts on mucous membranes

Warts with hair growing from them

Genitals

Infected, reddened, or irritated areas

• Stinging/burning of skin
• Dizziness
• Headache
• Tinnitus
• Mental confusion
• Peeling
• Scaling
• Burning/irritaion on normal tissue at site of exposure
• Hyperventilation

External topical use only

Avoid contact with eyes

Caution in infants, diabetics, or those with impaired circulation (diabetes)

Prolonged use over large areas, especially in children and those patients with significant renal or hepatic impairment, could result in salicylism

Avoid concomitant use of other drugs which may contribute to elevated serum salicylate levels when the potential for toxicity is present

In children <12 years and patients with renal or hepatic impairment, area to be treated should be limited and patient monitored closely for signs of salicylate toxicity, including nausea, vomiting, dizziness, loss of hearing, tinnitus, lethargy, hyperpnea, diarrhea, and psychic disturbances

In event of salicylic acid toxicity, discontinue use of SA 6%

Fluids should be administered to promote urinary excretion; treatment with sodium bicarbonate (oral or intravenous) should be instituted as appropriate

Patients should be cautioned against use of oral aspirin and other salicylate containing medications, such as sports injury creams, to avoid additional excessive exposure to salicylic acid

Where needed, aspirin should be replaced by alternative non-steroidal anti-inflammatory agent that is not salicylate based

Patients should be advised not to apply occlusive dressings, clothing or other occlusive topical products such as petrolatum-based ointments to prevent excessive systemic exposure to salicylic acid

Excessive application of product other than what is needed to cover affected area will not result in a more rapid therapeutic benefit

Due to potential risk of developing Reye’s syndrome, salicylate products should not be used in children and teenagers with varicella or influenza, unless directed by physician

Drug shown to be teratogenic in rats and monkeys; difficult to extrapolate from oral doses of acetylsalicylic acid used in these studies to topical administration as the oral dose to monkeys may represent six times the maximal daily human dose of salicylic acid when applied topically over a large body surface

Because of potential for serious adverse reactions in nursing infants from mother’s use of SA 6%, a decision should be made whether to discontinue nursing or discontinue drug, taking into account importance of drug to mother; if used by nursing mothers, should not be used on chest area to avoid accidental contamination of child

2 mg/kg/day PO (all formulations EXCEPT Absorica LD) for cystic acne; 1.6 mg/kg/day PO (Absorica LD) for cystic acne.

2 mg/kg/day PO (all formulations EXCEPT Absorica LD) for cystic acne; 1.6 mg/kg/day PO (Absorica LD) for cystic acne.

1 mg/kg/day PO (all formulations EXCEPT Absorica LD) for cystic acne; 0.8 mg/kg/day PO (Absorica LD) for cystic acne.

12 years: 1 mg/kg/day PO (all formulations EXCEPT Absorica LD) for cystic acne; 0.8 mg/kg/day PO (Absorica LD) for cystic acne.
younger than 12 years: Safety and efficacy have not been established.

Safety and efficacy have not been established.

Safety and efficacy have not been established.

Salicylic acid topical

topical liquid

• 0.5%
• 1%
• 2%
• 3%
• 6%
• 12.6%
• 13.6%
• 16.7%
• 17%
• 17.6%
• 26%
• 27.5%

gel

• 2%
• 6%
• 17%

lotion

• 3%
• 6%

cream

• 2%
• 6%

aerosol/foam

• 6%

soap

• 2%
• 3%

strips

• 40%

pad

• 40%

disk

• 40%

plaster

• 40%

patch

• 15%
• 40%

Salicylic acid acne

topical lotion

• 0.5%

topical cleanser

• 2%
• 0.5%

topical toner/astringent

• 2%

topical gel

• 2%

topical pads

• 2%

topical cream

• 2%
• 6%

topical foam/aerosol

• 6%

topical bar soap

• 2%

topical mask

• 0.5% plus East Indian sandalwood oil and French clay